North Carolina § 143C-4-11 - Medicaid Contingency Reserve.

§ 143C-4-11. Medicaid Contingency Reserve.

Medicaid Contingency Reserve. - The Medicaid Contingency Reserve is established as a reserve to be used only for budget shortfalls in the Medicaid or NC Health Choice program. Funds from the Medicaid Contingency Reserve may be allocated or expended only if all of the following criteria are met: There is an act of appropriation by the General Assembly. After the State Controller has verified that all Medicaid and NC Health Choice program receipts are being used appropriately, the Director of the Budget has found that additional funds are needed to cover a shortfall in the Medicaid or NC Health Choice budget for the State fiscal year. The Director of the Budget has reported immediately to the Fiscal Research Division on the amount of the shortfall found in accordance with subdivision (2) of this subsection. This report shall include an analysis of the causes of the shortfall, such as (i) unanticipated enrollment and mix of enrollment, (ii) unanticipated growth or utilization within particular service areas, (iii) errors in the data or analysis used to project the Medicaid or NC Health Choice budget, (iv) the failure of the program to achieve budgeted savings, (v) other factors and market trends that have impacted the price of or spending for services, (vi) variations in receipts from prior years or from assumptions used to prepare the Medicaid and NC Health Choice budgets for the current fiscal year, or (vii) other factors. The report shall also include data in an electronic format that is adequate for the Fiscal Research Division to confirm the amount of the shortfall and its causes. Nothing in this section shall be construed to limit the authority of the Governor to carry out the Governor's duties under the Constitution. History (2020-88, s. 14.) Editor's Note. - Session Laws 2020-88, s. 20, made this section effective July 2, 2020. Session Laws 2020-88, s. 5.5, provides: "Notwithstanding G.S. 143C-4-11 , as enacted by Section 14 of this act, the sum of one hundred thirty-six million dollars ($136,000,000) in nonrecurring funds for the 2020-2021 fiscal year shall be transferred from the Medicaid Contingency Reserve in the General Fund to the Department of Health and Human Services, Division of Health Benefits, to be used for the Medicaid and NC Health Choice programs rebase. Funds transferred under this section are appropriated for the purpose set forth in this section." Session Laws 2020-88, s. 15.2, provides: "Notwithstanding G.S. 143C-4-11 , as enacted by Section 14 of this act, the State Controller shall transfer funds from the Medicaid Contingency Reserve to the Department of Health and Human Services, Division of Health Benefits (DHB), only upon request by DHB as needed to cover any shortfall in receipts from the supplemental or base assessment under G.S. 108A-141 and G.S. 108A-142, enacted by subsection (b) of Section 15.1 of this act, and only if the following two conditions are met: "(1) The Office of State Budget and Management (OSBM) has certified that there will be a shortfall in receipts from the supplemental or base assessment. "(2) OSBM has certified that the amount requested by DHB does not exceed the shortfall in receipts certified by OSBM under subdivision (1) of this section. "Upon making the request to the State Controller for the transfer of funds pursuant to this section, DHB shall notify the Fiscal Research Division and the Joint Legislative Oversight Committee on Medicaid and NC Health Choice of the request and the amount of the request. To the extent any funds are transferred under this section, the funds are hereby appropriated for the purpose set forth in this section. The authority set forth in this section expires June 30, 2022."